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ENFORCEMENT DECREE OF THE ACT ON HOSPICE AND PALLIATIVE CARE AND DECISIONS ON LIFE-SUSTAINING TREATMENT FOR PATIENTS AT THE END OF LIFE

Presidential Decree No. 28206, Jul. 24, 2017

Amended by Presidential Decree No. 28620, Feb. 2, 2018

 Article 1 (Purpose)
The purpose of this Decree is to prescribe matters delegated by the Act on Hospice and Palliative Care and Decisions on Life-Sustaining Treatment for Patients at the End of Life and matters necessary for the enforcement of said Act.
 Article 2 (National Hospice and Palliative Care Committee)
(1) The term of office of commissioned members of the National Hospice and Palliative Care Committee (hereinafter referred to as the "Committee") established under Article 8 (1) of the Act on Hospice and Palliative Care and Decisions on Life-Sustaining Treatment for Patients at the End of Life (hereinafter referred to as "Act"), shall be three years and may be renewed only once: Provided, That the term of office of a member newly commissioned due to dismissal, etc., of a member shall be the remainder of his/her predecessor's term of office.
(2) Where any member of the Committee falls under any of the following cases, the Minister of Health and Welfare may remove or dismiss him/her from office:
1. Where he/she is incapable of performing his/her duties due to mental disability;
2. Where he/she has engaged in any irregularity in connection with his/her duties;
3. Where he/she is deemed unsuitable as a member due to neglecting duties, loss of dignity, or other reason;
4. Where he/she directly expresses that he/she cannot perform his/her duties.
(3) The chairperson of the Committee (hereinafter referred to as "chairperson") shall represent the Committee, and shall exercise overall control over the affairs of the Committee.
(4) Where the chairperson is unable to perform his/her duties due to any extenuating circumstance, a member designated by the chairperson shall act on his/her behalf.
(5) A meeting of the Committee shall be convoked at the request of the Minister of Health and Welfare or of at least one third of the members; or when the chairperson deems it necessary; and shall be presided over by the chairperson.
(6) A resolution by a meeting of the Committee shall require the a quorum of a majority of all incumbent members and concurrent votes of a majority of those present.
(7) The Committee shall have one executive secretary to conduct its administrative affairs, who shall be appointed by the Minister of Health and Welfare from among public officials of the Ministry of Health and Welfare.
(8) Commissioned members who attend a meeting of the Committee may be paid allowances, and reimbursed travel expenses and other necessary expenses within budgetary limits.
 Article 3 (Specialized Committees)
(1) The Committee may establish specialized committees, if necessary to technically examine the matters to be deliberated on by the Committee.
(2) Each specialized committee shall be comprised of not more than ten members including one chairperson, having due regard to gender equality.
(3) The chairperson and members of each specialized committee shall be appointed or commissioned by the Minister of Health and Welfare.
 Article 4 (Details for Operation Rules)
Except as otherwise expressly provided for in this Decree, details necessary for comprising, operating, etc. the Committee and specialized committees shall be determined by the Minister of Health and Welfare.
 Article 5 (National Agency for Management of Life-Sustaining Treatment)
(1) The head of the National Agency for Management of Life-Sustaining Treatment established under Article 9 (1) of the Act (hereinafter referred to as “Managing Agency") shall be appointed or commissioned by the Minister of Health and Welfare.
(2) If deemed necessary for efficiently operating the Managing Agency, the head of the Managing Agency may establish a steering committee comprised of specialists in the fields related to life-sustaining treatment, determination to terminate, etc., life-sustaining treatment, and executing the same, as determined by the Minister of Health and Welfare.
(3) If deemed necessary to perform the affairs under his/her jurisdiction, the head of the Managing Agency may request data or opinions from the heads of related central administrative agencies; the heads of local governments; the heads of public institutions under Article 4 of the Act on the Management of Public Institutions; and institutions, corporations, organizations, specialists related to health and medical services.
(4) The head of the Managing Agency shall report a plan for operating services, a performance record of services, a financial management plan, details of financial execution, etc., to the Minister of Health and Welfare, as determined by the Minister of Health and Welfare.
(5) "Affairs prescribed by Presidential Decree" in Article 9 (2) 5 of the Act means the following affairs:
1. Establishing and operating an information processing system necessary to perform the affairs set forth in Article 9 (2) 1 through 4;
2. Educating and providing information to founders of medical institutions, medical personnel or persons working for medical institutions on life-sustaining treatment, determination to terminate, etc., life-sustaining treatment, and the execution thereof;
3. Other affairs similar to those referred to in paragraphs 1 and 2, which the Minister of Health and Welfare deems particularly necessary regarding life-sustaining treatment, determination to terminate, etc., life-sustaining treatment, and the execution thereof.
 Article 6 (Preparation of Life-Sustaining Treatment Plans)
"Method equivalent thereto prescribed by Presidential Decree" in Article 10 (4) 2 of the Act means video recording.
 Article 7 (Requirements for Designation of Agency for Registration of Advance Statements on Life-Sustaining Treatment)
(1) The requirements for designation of an agency for registering advance statements on life-sustaining treatment referred to in Article 11 (1) of the Act (hereinafter referred to as "registration agency") shall be as follows:
1. It shall have an office and a counseling office in which the affairs under its jurisdiction can be performed independently;
2. It shall be equipped with an online work processing system;
3. It shall have at least one exclusive department and two workers capable of professionally performing the affairs under its jurisdiction.
(2) Details of the criteria for designation under paragraph (1) and matters necessary for operating, etc., the same shall be determined and publicly notified by the Minister of Health and Welfare.
 Article 8 (Transfer of Records)
(1) When the head of a registration agency intends to transfer records kept pursuant to Article 13 (3) of the Act to the head of the Managing Agency, he/she shall transfer them within 30 days from the date on which the designation of a registration agency is revoked.
(2) When the head of a registration agency transfers records kept pursuant to Article 13 (3) of the Act to the head of the Managing Agency, he/she shall prepare a complete list of the records kept and submit it together.
(3) Except as otherwise expressly provided for in paragraphs (1) and (2), detailed procedures, methods, etc., necessary for transferring the records kept by the head of a registration agency shall be determined and publicly notified by the Minister of Health and Welfare.
 Article 9 (Determining to Terminate, etc., Life-Sustaining Treatment where It is Impossible to Confirm Patient's Intention)
(1) "Those who fall under any ground prescribed by Presidential Decree, such as missing persons" in Article 18 (1) 2 of the Act means any of the following persons:
1. A person in whose case at least three years have passed since his/her disappearance was reported to a police office;
2. A person judicially declared missing;
3. A person whose medical condition has been diagnosed and confirmed by at least one specialist, as a person whose medical condition prevents him/her from expressing his/her own intention due to unconsciousness or similar reasons.
(2) Where a patient's family member makes a determination to terminate, etc., life-sustaining treatment pursuant to Article 18 (1) 2 of the Act, if any family member of the patient falls under any subparagraph of paragraph (1), a document substantiating the relevant fact shall be submitted to the doctor in charge.
 Article 10 (Preservation of Records Related to Determination to Terminate, etc., Life-Sustaining Treatment)
"Matters prescribed by Presidential Decree" in subparagraph 7 of Article 20 of the Act means the records concerning deliberation performed by an institutional ethics committee under Article 14 (2) 1 or 2 of the Act.
 Article 11 (Entrustment of Hospice and Palliative Care Projects)
(1) Pursuant to Article 21 (2) of the Act, the Minister of Health and Welfare may entrust the projects prescribed in Article 21 (1) to any of the following specialized institutions or organizations:
1. The Central Hospice Center referred to in the forepart of Article 23 (1) of the Act (hereinafter referred to as the "Central Center");
2. A regional hospice center referred to in the forepart of Article 24 (1) of the Act (hereinafter referred to as "regional center");
3. A public institution, the objective for establishing which is related to health and medical services, among public institutions under Article 4 of the Act on the Management of Public Institutions;
4. An institution or organization determined and publicly notified by the Minister of Health and Welfare, as an institution or organization having an organizational structure, human resources, expertise, etc., necessary to perform the entrusted affairs.
(2) Where the Minister of Health and Welfare intends to grant entrustment pursuant to Article 21 (2) of the Act, he/she shall publicly preannounce matters concerning the standards and procedures for, and methods, etc., of the entrustment.
(3) Where the Minister of Health and Welfare has granted entrustment pursuant to Article 21 (2) of the Act, he/she shall publicly notify the matters concerning the details of the entrustment and the assignee in the Official Gazette and post them on the website of the Ministry of Health and Welfare.
(4) A specialized institution or organization entrusted pursuant to Article 21 (2) of the Act shall report the project operation plan, outcomes of operating the project, financial management plan, outcomes of the financial management, etc., to the Minister of Health and Welfare.
(5) Detailed matters necessary for publicly notifying entrustment standards, public announcement of the details of entrustment, reporting on entrusted affairs, etc., under paragraphs (2) through (4) shall be determined and publicly notified by the Minister of Health and Welfare.
 Article 12 (Entrustment of Evaluation Affairs of Institutions Specialized in Hospice Care)
(1) Pursuant to Article 29 (4) of the Act, the Minister of Health and Welfare may entrust any of the following specialized institutions or organizations with the affairs related to evaluating institutions specialized in hospice care designated under Article 25 (1) of the Act (hereinafter referred to as “institutions specialized in hospice care”): <Amended by Presidential Decree No. 28620, Feb. 2, 2018>
1. The Central Center;
2. A public institution, the objective of establishing which is related to health and medical services, among public institutions under Article 4 of the Act on the Management of Public Institutions;
3. An institution or organization determined and publicly notified by the Minister of Health and Welfare, as an institution or organization having the organizational structure, human resources, expertise, etc., necessary to perform the entrusted affairs.
(2) Where the Minister of Health and Welfare entrusts the affairs related to evaluating institutions specialized in hospice care pursuant to Article 29 (4) of the Act, Article 11 (2) through (5) shall apply mutatis mutandis to the public announcement of the standards for such entrustment and the public notification of the details of entrustment, reporting on entrusted affairs, etc.
 Article 13 (Management of Sensitive Information and Personally Identifiable Information)
(1) The Minister of Health and Welfare (including persons to whom the affairs of the Minister of Health and Welfare is entrusted under Articles 11 (1) and 12 (1)), the head of the Central Center (limited to the affairs referred to in subparagraph 3), the head of a regional center (limited only to the affairs referred to in subparagraph 5), or an institution specialized in hospice care (limited only to the affairs referred to in subparagraph 6-2) may manage data containing information on health under Article 23 of the Personal Information Protection Act, and resident registration numbers, passport numbers, or alien registration numbers under Article 19 of the Enforcement Decree of the same Act, if it is inevitable to perform the following affairs: <Amended by Presidential Decree No. 28620, Feb. 2, 2018>
1. Affairs concerning executing projects for hospice and palliative care under Article 21 (1) of the Act;
2. Affairs concerning designating the Central Center;
3. Affairs prescribed in Article 23 (1) 1, 2, 5 and 6 of the Act;
4. Affairs concerning designating a regional center;
5. Affairs prescribed in Article 24 (1) 1, 4 and 7 of the Act;
6. Affairs concerning designating and changing an institution specialized in hospice care under Articles 25 (1) and 26 (1) of the Act;
6-2. Affairs concerning applying for and withdrawing the use of hospice and palliative care under Article 28 of the Act;
7. Affairs concerning the evaluation of institutions specialized in hospice care under Article 29 of the Act.
(2) A doctor in charge or a medical specialist in the relevant field (limited only to the affairs referred to in subparagraphs 2 through 4) may manage data containing information on health under Article 23 of the Personal Information Protection Act, and resident registration numbers, passport numbers, or alien registration numbers under Article 19 of the Enforcement Decree of the same Act, if it is inevitable to perform the following affairs: <Newly Inserted by Presidential Decree No. 28620, Feb. 2, 2018>
1. Preparing, amending, or withdrawing life-sustaining treatment plans under Article 10 of the Act;
2. Recording the outcome of diagnosing whether a patient is in end-of-life process under Article 16 of the Act;
3. Verifying a patient’s intention to make a determination to terminate, etc., life-sustaining treatment, inquiring about the registration of the Managing Agency, and recording the outcome of verifying the patient’s intention under Article 17 of the Act;
4. Verifying a patient’s intention to make a determination to terminate, etc., life-sustaining treatment under Article 18 of the Act and recording the outcome of such verification;
5. Implementing a determination to terminate, etc., life-sustaining treatment under Article 19 of the Act.
 Article 14 (Administrative Fines)
The criteria for imposing administrative fines under Article 43 (1) through (3) of the Act shall be as specified in the attached Table.
ADDENDA
Article 1 (Enforcement Date)
This Decree shall enter into force on August 4, 2017: Provided, That Articles 5 through 10 and subparagraph 2 of the attached Table (excluding items (g) and (h); this applies only to hospice and palliative care) shall enter into force on February 4, 2018.
Article 2 (Special Cases concerning Entrustment, etc., of Hospice and Palliative Care Projects)
(1) Pursuant to Article 11, the Minister of Health and Welfare shall entrust the relevant hospice and palliative care projects (limited to those for patients having terminal cancer) to the National Cancer Center established under Article 27 of the Cancer Control Act (hereafter in this Article referred to as the "National Cancer Center") until hospice and palliative care projects are entrusted pursuant to Article 21 (1) 1, 2, 4, 5 and 8 of the Act.
(2) The president of the National Cancer Center entrusted with the hospice and palliative care projects referred to in Article 21 (1) of the Act pursuant to paragraph (1), may manage data containing information on health under Article 23 of the Personal Information Protection Act, and resident registration numbers, passport numbers, or alien registration numbers under Article 19 of the Enforcement Decree of the same Act, if it is essential to performing the relevant affairs.
Article 3 Omitted.
ADDENDUM <Presidential Decree No. 28620, Feb. 2, 2018>
This Decree shall enter into force on February 4, 2018.